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Anal Sex & HIV Positive, is it safe?The Body: Rick Sowadsky M.S.P.H., C.D.S, Answers to Safe Sex Questions

Jan 31, 1997

I am HIV+ with very low T-cells (11) and moderately low viral load (18,000). I have been having anal sex with my partner who wears a condom. There is some bleeding after having sex -- my partner is concerned that it isn't safe for me. Is it safe for me to have anal sex with this bleeding?

Response from Mr. Sowadsky

Hi. Thank you for your question.

There is no simple answer to this question. There would potentially be a risk to you if any infectious diseases (especially bacterial infections) were to gain an access to your bloodstream while you were actively bleeding anally. When you bleed, the cuts give bacteria an access to your bloodstream. When the immune system functions properly, the immune system can often get rid of these invading bacteria when they enter the bloodstream. However, since your immune system is very damaged, you are more likely to become ill, if the bacteria were to enter your bloodstream. Bacteria in the bloodstream can be very serious if your immune system cannot fight them off. Interestingly enough, I have not seen any studies looking specifically at whether there are increased risks of bacterial infections in the blood, in HIV positive persons continuing to engage in anal sex. However, the possibility remains, especially if you are actively bleeding. It is NOT my position to tell you whether you should stop having anal sex or not. That's a personal decision. However, I do strongly suggest that you use more lubrication during anal sex, which may reduce the amount of friction, which then may decrease the amount of bleeding that you are having. However, beyond what I have discussed here, it's hard for me to say if you are putting yourself at increased risk, by continuing to have anal sex and continuing to bleed.

If you have any further questions, please feel free to contact the Centers for Disease Control at 1.800.232.4636 (Nationwide).

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